Science & Medicine Links for August

Case report from the BMJ that would also make a good Twilight Zone episode: Woman hallucinates ghost children. Husband takes pictures of scene to try to prove that there’s nobody there. Woman sees exact same hallucinations in the photographs. Woman takes some psychiatric drugs, mostly stops having hallucinations, but still sees the hallucinatory ghost children in the (empty to everyone else) old photos. Psychiatry is weird, and/or possibly haunted.

A while ago there was great excitement at the discovery that the drug rapamycin extended lifespan in mice. Although this finding has since been replicated and seems broadly correct, the bad news seems to be that is now clear that the drug just treats some very specific deadly pathologies (like cancer) and does not fight or slow aging. Although if the bad news is that a drug cures cancer, we’re still doing pretty well.

Speaking of miracles, Skin Abnormality May Prove Biological Basis For Fibromyalgia. I predict this will probably turn out to be nothing, the same way everyone was super excited a few years ago that we’d discovered that the real cause of multiple sclerosis was venous outflow obstruction and then it didn’t replicate, but until then at least fibromyalgia sufferers will get a few good years in of “SEE! I TOLD YOU IT WAS BIOLOGICAL AND YOU DIDN’T BELIEVE ME!”

Not technically a study but a good thing to include here: Eight Toxic Foods and a Little Chemical Education. Describes some of the scare claims the media sometimes makes about chemicals and health risks and dissects them carefully and rigorously.

And if that was too basic for you, here’s the Epic-level version of the same thing: the Last Psychiatrist dissects claims made in a presentation on the drug Geodon. This is old, but I just found it and it terrifies me, in that I thought I knew what to look for and yet this study would have completely passed all the filters I usually have to protect myself from this sort of thing. A good example of how a drug company can run a seemingly rigorous study that stays far away from anything even resembling data falsification or cover-ups – and yet still get exactly the results they want.

Back when people realized it was easy to get positive results from a drug for spurious reasons, they started adding a control group to the experiment. Now that people have realized it’s easy to get positive results from a controlled trial for spurious reasons, is it time to go one meta-level up and add a control experiment on to the study? One group takes an experiment used to “prove” that SSRIs cause gastric bleeding, compares it to dozens of “control experiments” run with drugs that don’t cause gastric bleeding, and finds that, although the real experiment reported positive results, it in fact does no different than placebo experiments. This is really clever although probably impractical in most cases.

Psychotherapy over the Internet works at least as well and probably better than face-to-face psychotherapy, says a study this month, adding to the small mountain of evidence saying the same. A friend of mine uses online psychotherapy and says it’s easier and more productive because the therapist is less of a Terrifying Authority Figure. Also good for people who want a psychologist who will have severe difficulty calling the cops on them and having them committed. Also good for social phobics who are currently required to leave the house and hang out at a busy medical office if they want to get treatment for their social phobia who the heck came up with this system?

“Adoption study of human obesity” sounds like something you would get from a Things Scott Is Interested In Mad Libs, along with “utilitarian behavioral genetics” or “double-blind placebo-controlled cuddling of cute girls”. But it turns out this is a real field that various people have looked into, and the conclusion of most of the studies, including a very rigorous one in Denmark published in NEJM and a huge UK one by Robert Plomin agree that whether the parents who raise you are obese has zero impact on whether you will become obese, but whether your biological parents whom you may never meet are obese has massive impact on whether you will become obese. This doesn’t completely disprove the idea that the childhood environment affects obesity – it could still be that whether or not parents are good at teaching their children not to be obese just has zero correlation with whether the parents themselves are obese – but it sure casts a lot of doubt on environmental hypotheses and confirms that genetics plays a very big role.

On the other hand, here’s a study from 2011 which shows that people with lower Conscientiousness and higher Impulsivity are much more likely to be obese – “Participants who scored in the top 10% of impulsivity weighed, on average, 11 kg more than those in the bottom 10%”. LWers pointed out that this is not itself incompatible with genetics, since most personality traits are themselves somewhat heritable.

JAMA Psychiatry: Rapid Improvement of Acute Schizophrenia Symptoms After Intravenous Sodium Nitroprusside. Anything that improves schizophrenia symptoms is good news, but this is especially interesting for two reasons. First, the rapid and dramatic effect is easier to replicate and less corruptible than the usual “take this pill for a month and maybe you will feel better”, and is reminiscent of the very similar effect of ketamine on depression. Second, sodium nitroprusside is a drug used for high blood pressure without any previously known relevance to psychiatry, opening up a whole new direction in research. The small but interesting field of nitric oxide in schizophrenia is about to get a lot more scrutiny.

11 Responses to Science & Medicine Links for August

Not particularly surprising, except for the regional variation. Did all the fat ancestors get shipped to america? Or am I in error in thinking stereotypes hold up?

Also, if that’s an adoption study, could the biological heritability be epigenetic? I am not a biologist, but that would seem to explain why populations with otherwise similar genetic heritage have differences in apparently heritable obesity, right?

>On the mutant third hand,

The term is “on the gripping hand”. Did you neglect to read Niven, or are you assuming we didn’t?

That’s real Department of the Bleedin’ Obvious stuff as far as I’m concerned; goodness, genetics might have a role in whether you tend to pack on the pudge or not? I never would have suspected that, from my family where two of us take after my father’s side of the family (pudgy) and two of us take after my mother’s side of the family (not pudgy) and we were all reared by the same two parents eating the same food.

Also, in that fibromyalgia article, why is the tone very strongly “if it’s ‘all in your head’, it’s not really real”? Even an imaginary pain hurts, and it’s not much good telling someone “We can’t find a reason why you should have a pain from the blood test or the x-ray, so you don’t really have a pain, you only think you have a pain.” Believe me, that pain hurts just as much as if you had a ‘rational biological basis’. Three years ago I got a severe bout of abdominal pain (to the point where I hauled myself into the ER of the regional hospital at 4 o’clock in the morning on Good Friday) which had been diagnosed as “probably urinary tract infection” (it wasn’t), “maybe gallbladder” (no), “could be your appendix” (not that either) and ended up being “Well, since you’re female, it could be any number of things”. It went away of its own accord and I’ve never had an explanation for why it happened, what it was, or why it stopped – but believe me, at 3 a.m. I was seriously considering slicing my side open with the sharp steak knife to relieve the pressure because it couldn’t hurt any worse than it already did, and surely I wouldn’t bleed thatmuch. I didn’t, but it really was a close-run thing.

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